Clinical nurses in Magnet hospitals confirm productive, healthy unit work environments

Abstract

To describe extent to which experienced nurses in Magnet hospitals confirm healthy work environments (HWE). Differentiating differences in HWE allows managers to focus attention where changes may be needed to improve nurse and patient outcomes. The sample was 12,233 experienced nurses from 717 clinical units in 34 Magnet hospitals. Based on Essentials of Magnetism II unit level scores, units were grouped as very healthy work environments (VHWE), HWE or work environments needing improvement. VHWE or HWE was confirmed by nurses on 82% of 540 clinical units. The most significant correlates of HWE units occur within individual hospitals. More nurses prepared at the Bachelor of Science in Nursing level or above work on VHWE or HWE units and score higher on seven essential work processes. Nurses' ratings of quality of patient care directly correlate to quality of work environment. Clinical units in 34 Magnet hospitals were markedly skewed toward excellence. Visionary leadership, empowerment and collaboration have an impact on development and maintenance of HWE. Implementation of structures that promote interdisciplinary and intradisciplinary collaboration and decision-making positively affect development of HWE. Gap analysis of the steps/components of the eight work processes/relationships essential to HWE may enable achievement of HWEs on all hospital clinical units.